United States Department of Agriculture - USDA/1890 National Scholars Program 2021 High School Application

Page created by Ellen Berry
 
CONTINUE READING
OMB No:0503-0015

    United States Department of Agriculture

              USDA/1890 National Scholars Program
                        2021 High School Application

USDA is an equal opportunity provider and employer
                                                              1|Page
OMB No:0503-0015

INTRODUCTION
Thank you for your interest in the U.S. Department of Agriculture’s (USDA’s) 1890 National
Scholars Program. The USDA/1890 National Scholars Program was established in 1992 as part
of the partnership between the U.S. Department of Agriculture and the 1890 Land-Grant
Universities.
The goal of the USDA/1890 National Scholars Program is to increase the number of students
studying agriculture, food sciences, natural resource sciences, and other related disciplines. The
program is open to high school seniors, college freshmen and sophomores who exhibit
exemplary leadership traits and demonstrated community service. The Scholarship is highly
competitive and provides for full tuition payment, among other benefits, for up to 4-years to
selected students enrolled or accepted for enrollment at an 1890 Land-Grant University. The
1890 National Scholars Program partners with USDA agencies to provide scholars with
professional and educational opportunities. A sponsoring USDA Agency Coordinator will be
assigned to the scholar. However, the USDA Liaison will be the primary point of contact for the
scholar. The USDA Sponsoring Agency will work closely with scholars to provide ongoing
support and ensure the scholar is on track with degree requirements.
The USDA/1890 National Scholars Program is implemented under the USDA Fellows
Experience Program (FEP). Successful applicants will receive a temporary appointment to the
USDA, not to exceed 4 years. Upon successful completion of the degree requirements and the
end of the agreement period, the scholar is eligible for conversion to a career conditional
appointment in service to USDA without further competition.

The USDA/1890 National Scholar is required to:
     Reimburse the USDA Sponsoring Agency for costs of education (excluding the employee’s pay
      and allowances) incurred by the USDA sponsoring agency, if the scholar voluntarily separates
      from the service of the USDA sponsoring agency before the end of the period for which the
      scholar has agreed to continue in the service of the USDA.

     Consult with and obtain the approval of the USDA Liaison and Sponsoring USDA Agency prior
      to making any changes to their academic program. Unapproved changes may affect the Scholar’s
      continued participation in the program, such as scholar’s participation in study abroad programs,
      third party internships and leave of absence. The Scholar is expected to meet with the USDA
      Liaison and Agency Coordinator to go over degree classes and ongoing academic status.

     The Scholar must coordinate summer work experience through their work site manager.

     The Scholar must report to work site and have a record of their individual development plan.

Again, thank you for your interest in the USDA/1890 National Scholars Program and best wishes
in your pursuit of academic excellence!
USDA is an equal opportunity provider and employer
                                                                                            2|Page
OMB No:0503-0015

USDA/1890 NATIONAL SCHOLARS PROGRAM
OVERVIEW and AUTHORITIES
The USDA/1890 National Program is a partnership between the U.S. Department of Agriculture
(USDA) and the 1890 Land-Grant Universities. The program awards scholarships to students
accepted to or attending one of the 1890 Land-Grant Universities in pursuit of a bachelor’s
degree in agriculture, food sciences, natural resource sciences, or related academic discipline(s).
The Land-Grant Universities are as follows:

    Alabama A&M University (Alabama)          North Carolina A&T State University (North Carolina)
    Alcorn State University (Mississippi)     Prairie View A&M University (Texas)
    Central State University (Ohio)           South Carolina State University (South Carolina)
    Delaware State University (Delaware)      Southern University (Louisiana)
    Florida A&M University (Florida)          Tennessee State University (Tennessee)
    Fort Valley State University (Georgia)    Tuskegee University (Alabama)
    Kentucky State University (Kentucky)
                                              University of Arkansas Pine Bluff (Arkansas)
    Langston University (Oklahoma)
                                              University of Maryland Eastern Shore (Maryland)
    Lincoln University (Missouri)
                                              Virginia State University (Virginia)
                                              West Virginia State University (West Virginia)

•     Legislative Authority of the Second Morrill Act of August 30, 1890 (7 U.S.C. 321-326 and
      328);
•     National Agricultural Research, Extension and Teaching Act of 1977 (Public Law 95-113,
      1402, et seq7 U.S.C. §3101);
•     Office of Personnel Management, Training (5 C.F.R part 410);
•     Schedule A (r) federal Experience Authority (5 C.F.R. 213.312 ((r));
•     Federal Agriculture Improvement and Reform Act of 1996 (FAIR ACT), Title IX, Section
      922 (7 U.S.C § 2279c);
•     Executive Order 13779, White House Initiative on Historically Black Colleges and
      Universities, signed February 18, 2017 continued by Executive Order 13811, signed
      September 29 September 2017.
•     Conversion to Career Conditional Appointment Farm Bill 2018 (5 CFR 213.3102) authority
      code “ZLM”.

USDA is an equal opportunity provider and employer
                                                                                         3|Page
OMB No:0503-0015

PURPOSE
The purpose of the USDA/1890 National Scholars Program is:
     To strengthen the long-term partnership between USDA and the 1890 Land-Grant
      Universities.
     To promote increase and cooperation among the parties in all areas of mutual interest.
     To improve USDA’s outreach efforts within the communities served by 1890 Land-Grant
      Universities and USDA.
     To increase the number of students studying and pursuing careers in agriculture, food
      sciences, and natural resource sciences or other related disciplines.
OBJECTIVE
The USDA/1890 National Scholars Program offers scholarships to U.S. citizens who are seeking
a bachelor’s degree at one of the 1890 Land-Grant Universities in any of the fields of study
within agriculture, food sciences, natural resource sciences, or other related disciplines.
Examples of required fields of study or related disciplines are:
•   Agribusiness                                     •   Family and Consumer Sciences
•   Agriculture/Biological Regulatory Science        •   Farm and Range Management
•   Agricultural Production and Technology           •   Financial Management
•   Agronomy or Crop Sciences                        •   Forestry and Related Sciences
•   Agricultural Economics                           •   Horticulture
•   Agricultural Engineering/Mechanics               •   Natural Resources Management
    Sciences                                         •   Nutrition
•   Animal Sciences                                  •   Soil Conservation /Soil Science
•   Aquaculture/Fisheries                            •   Water Resource Management
•   Biological System Engineering                    •   Other Related Disciplines (e.g., pre-
•   Botany                                               veterinary medicine, veterinary
•   Business Management                                  technology, computer sciences, non-
•   Entomology                                           medical biological sciences)

AWARD
Scholarships are awarded annually and must be used at one of the 1890 Land-Grant Universities.
Each award is renewable each year for the term of the scholarship and provides full tuition, fees,
books, and room and board. The scholarship renewal is contingent upon satisfactory academic
performance, summer work performance and academic progress toward the bachelor’s degree.

USDA is an equal opportunity provider and employer
                                                                                          4|Page
OMB No:0503-0015

GENERAL ELIGIBILITY

Applicant must:

     Be a U.S. citizen
     Intend to study agriculture, food sciences, natural resource sciences, or other related
        academic disciplines
     Have a high school cumulative unweighted GPA of 3.0 or better (on a 4.0 scale)
     Have applied for admission to an 1890 Land-Grant University.
     Demonstrate leadership and community service

INSTRUCTIONS
Only completed application packages submitted by the deadline will be considered. All
application materials must be submitted in one application package. Complete application
packages must include the following:

     Signed and dated application including signature of parent of guardian, if the applicant is
        under the age of 18, a Completed Privacy Act Advisory Statement and Release Form (no
        copies – only original signatures will be accepted)
     Completed Biographical Questionnaire
     High School Counselor’s Assessment Report in a sealed envelope
     High School Teacher’s Assessment Report in a sealed envelope
     Submit the most recent official transcript with the school seal and/or the signature of an
        authorized school official
     Submit a 500-800-word essay on one (1) of the following topics.
                o My interest in working for USDA.
                o How I envision the scholarship will impact me personally and my future as a
                  public servant.
                o My experiences and perceptions about agriculture, food sciences and natural
                  resource sciences or other related disciplines as related to agriculture.

     Submit an original signed and dated application

Applicants are responsible for obtaining the Assessment Reports from the High School
Counselor and the High School Teacher. These Assessment Reports should be in a sealed
USDA is an equal opportunity provider and employer
                                                                                        5|Page
OMB No:0503-0015

envelope and included with the application package. All application materials must have original
signatures and seals/stamps.

Application materials containing photocopied signatures and transcripts will not be considered
for the USDA/1890 National Scholars Program scholarship.

APPLICATION DEADLINE:

All application materials must be postmarked no later than January 31, 2021 and sent to the
USDA Liaison at the university or universities selected by the applicant.

SELECTION PROCESS

If selected, the student will be contacted by the sponsoring Agency Coordinator. The applicant
will be given an opportunity to ask questions related to the agency, job, and program
expectations. Selected applicants should contact their USDA Liaison and Agency Coordinator
with any unanswered questions or concerns related to the agency, summer experience, or
academic requirements.

Applications Must Be Postmarked by January 31, 2021.

Note: The application may also be printed out and filled in by hand in black or blue ink only.

USDA is an equal opportunity provider and employer
                                                                                        6|Page
OMB No:0503-0015

PRIVACY ACT ADVISORY STATEMENT
The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in
connection with this request for information. Accordingly, pursuant to the requirements for this
Act, please be advised:

1.      Furnishing the information requested is voluntary.

2.      The data will be used for selection of 1890 National Program, printing certificates, and
        related activities.

3.      The data is maintained in a privacy act system as defined by National Archives and
        Records Administration under OMB.

4.      Failure to complete this form will mean you cannot be included among those candidates
        being considered for designation as a USDA/1890 National Scholar.

I,                             understand that I am a candidate for the USDA/1890 National
Scholars Program, have read the Privacy Act Advisory Statement, and affirm my wish to be
considered. In the event I am selected as a Scholar, permission is hereby given for the release of
materials submitted by me for the use of the U.S. Department of Agriculture and the 1890 Land-
Grant Universities as deemed appropriate for purposes of the USDA/1890 National Scholars
Program.

I further consent to the release of photographs that may be taken of me, by or for the U.S.
Department of Agriculture. I am (check one)           willing       unwilling to appear on radio
and/or television if such arrangements are made by the U.S. Department of Agriculture.

Print Name

Signature

Date

Note: Original signatures only. Photocopies will not be accepted.

USDA is an equal opportunity provider and employer
                                                                                        7|Page
OMB No:0503-0015

Candidate’s Biographical Questionnaire (Please Print)
The following questions are designed to collect information about your background, your
interests, and your plans. Your answers to these questions will be used only in connection with
your application for this scholarship program and will be divulged only to qualified persons who
must see them during their duties.

A. Biographical Information

Legal Name

Last Name                                         First Name                         M.I.

Sex:            Male              Female

Permanent Address

City                              State                    Zip Code

U.S. Citizen           Yes          No

Telephone (Home)

Telephone (Cell)                                        Email Address

B. Education

Name of Current High School

Address

City                                      State                           Zip Code

Telephone

GPA (on a 4.0 unweighted scale) _________________________________

Note: Grade point averages and standardized test scores should match supporting documentation
submitted by counselor. Do not apply if you do not meet these criteria.

USDA is an equal opportunity provider and employer
                                                                                            8|Page
OMB No:0503-0015

  1. List any other schools that you attended in the last 4 years. List the schools in
     order of attendance, with the one you attended most recently listed first.
Name of school                 Location (City & State)       Dates of Attendance

   2. List any advanced or special program, courses, or summer courses you have taken.
      List the most recent course or program first.
 Course or        Name of            Address         Dates of         Hours per Week
 Program          School                             Attendance

    3. Name(s) of the 1890 University (or Universities) to which you are applying, in
       order of preference (i.e. 1 =Most Preferred, 3=Least Preferred):

            1.

            2.

            3.

Note: Applicants applying to more than one 1890 Land-Grant University must submit separate 1890
National Program applications for each university.

USDA is an equal opportunity provider and employer
                                                                                       9|Page
OMB No:0503-0015

    4. What course of study (major) will you pursue?
       1st Choice

        2nd Choice

        Other Related Discipline/Unlisted Major (Please Identify):

        Note: All academic disciplines may not be available at every 1890 Land-Grant University.
        Check the University’s academic offerings before applying.

    5. Have you made career decisions related to agriculture, food sciences, natural
       resource sciences or related disciplines?
               Yes                 No

        If yes, please explain below:

USDA is an equal opportunity provider and employer
                                                                                      10 | P a g e
OMB No:0503-0015

C. Activities
1. List extracurricular activities in which you have participated in school or in the
community (i.e. academic activities such as 4-H, FFA, debate, sports, music, art, etc.).
 Activity                Dates of               Office(s) Held         Special Award(s)
                         Participation

2. List volunteer and paid positions you have held in the past 4 years (including summer
employment).
 Volunteer or   Employer/Organization Date of Service         Hours      Special Award(s)
 Paid Positions                       or Employment           per
                                                              Week

USDA is an equal opportunity provider and employer
                                                                                11 | P a g e
OMB No:0503-0015

D. Candidates Self-Assessment

    1. Please list your hobbies and how each plays a role in your personal development.

    2. Describe activities in which you had a leadership role in your school or in your
       community.

USDA is an equal opportunity provider and employer
                                                                                12 | P a g e
OMB No:0503-0015

    3. Describe a recent experience that has given you a sense of satisfaction or pride.

    4. Briefly discuss why have you chosen to study agricultural, or a related discipline.

USDA is an equal opportunity provider and employer
                                                                                 13 | P a g e
OMB No:0503-0015

Review this form to make sure you have answered all questions completely. Proofread
your responses.

I certify that I have completed this application and that all statements are true and
accurate to the best of my knowledge. I understand that a false statement could
eliminate me from consideration for this scholarship.

Print your Legal Name:

Applicant’s Signature:

Date Signed:

Parent/Legal Guardian Signature:

Print Name (Parent or Legal Guardian): Note: If the applicant is a child, under the age of 18,
parental or legal guardian signature is required.

Parent or Legal Guardian Signature:

Date Signed:
Note: This form and all other application materials must be postmarked by January 31, 2021.

USDA is an equal opportunity provider and employer
                                                                                        14 | P a g e
OMB No:0503-0015

How did you hear about the 1890 National Scholars Program Scholarship? (Select all that
apply.)

        College Fair(s):
        Name of Event(s):

        Informational Session:
        Location:

        Public Service Announcement:
        Stations:

        Direct Mail/E-mail:
        Source of Communication:

        USDA Employee:
        Name of Employee(s):

        Church or Place of Worship:
        Name of Facility:

        Website(s):
        Name of Website(s):

        Social Media:
        Name of Site/App(s):

USDA is an equal opportunity provider and employer
                                                                            15 | P a g e
OMB No:0503-0015

        USDA/1890 NATIONAL SCHOLARS PROGRAM SCHOLARSHIP
       Applicant’s Authorization to Release Academic Information (for Counselor)

Applicant’s Full Name

Last                                First                     Middle                   Suffix

To comply with the provisions of the Family Educational Rights and Privacy Act of
1974, a school must obtain signed authorization before it can release student information
for use in this scholarship program. Permission is hereby given to school officials to
release record and other requested information for consideration in the scholarship
program named above. Note: If the applicant is a minor child, under the age of 18; parental or
legal guardian signature is required.

Student’s Signature

Date

Parent or Legal Guardian Signature

Date

Applicant: If you have attended this school less than 2 years, you must copy this form

and have your previous school also complete this form for you.

School Name

Address

City                                    State          Zip Code         Phone Number

USDA is an equal opportunity provider and employer
                                                                                   16 | P a g e
OMB No:0503-0015

                   USDA/1890 National Scholars Program Scholarship
                                Secondary School Report
                   High School Guidance Counselor Assessment Report

A. Please type or print using black ink

Name of Counselor

_______________________                 _________________     ______                  _____
Last                                    First                 MI                      Suffix

Address:

________________________________________________________________________

Phone: _________________

B. Are you confident that the student will receive a high school diploma during the
current academic year?

Yes             No

If your answer is no, please explain your reason using a separate page

C. Student’s class rank ___________________

How many students are in the class? ________________

D. Student’s cumulative grade point average (unweighted on 4.0 scale) __________
   Do not enter GPA on a scale of 0-100.

USDA is an equal opportunity provider and employer
                                                                               17 | P a g e
OMB No:0503-0015

E. Secondary School Record

The applicant’s official secondary school transcript (with seal and signature by an
authorized official), including grades 9 through 12 must be attached to this section of the
application. If the official transcript is not provided, the applicant will not be considered
for the scholarship.

Note: If the applicant is enrolled in official college courses (i.e. dual degree), please submit an official
transcript from the college as well.

Counselor’s Signature __________________________________________

Date ________________________________________________________

This form and the candidate’s transcript must be included in the student’s application
package. Applicants applying to more than one 1890 Historically Black Land-Grant
University must submit separate USDA/1890 National Scholars application packages for
each school. The complete application packages must be postmarked by January 31,
2021.

USDA is an equal opportunity provider and employer
                                                                                                18 | P a g e
OMB No:0503-0015

                         USDA/1890 National Scholar Program
                Secondary School Report School Teacher Assessment Report
The application for the USDA/1890 National Scholars Program scholarship requires a
carefully considered character and ability assessment by a teacher who knows the student
well, including a summary of other teachers’ judgments of the student.

Applicant’s Full Name

Last                                First                 Middle                  Suffix

    A. Name of Teacher

Last Name                       First Name               Middle Name     Suffix

Address                                                         Phone Number

    B. Length of Relationship

    C. Considering this student’s interests, work habits, and life goals, what is your
       assessment as to whether the student will be motivated to take advantage of the
       opportunities available in college? Please give reasons for your assessment.

USDA is an equal opportunity provider and employer
                                                                               19 | P a g e
OMB No:0503-0015

    D. What special features are a part of your school’s curriculum (e.g., AP and honors
       courses, college study, and independent study)? Has the student taken advantage
       of the most challenging opportunities your school has to offer?

    E. Has the student shown exceptional talent or originality in agriculture, food
       sciences, natural resource sciences, and/or other related disciplines?
              Yes            No

        Please explain in this section:
        Strengthens:

        Weaknesses:

USDA is an equal opportunity provider and employer
                                                                                20 | P a g e
OMB No:0503-0015

    F. Sometimes, special circumstances should be considered when evaluating a
       student’s achievement records and test scores. If in your opinion, this student may
       have been disadvantaged by any such circumstances, please specify. *Additional
       pages may be attached if needed. *

    G. Indicate comments made by teachers about the student relative to the
       following:

        1. Participation in discussion:
                  Always involved, often initiates discussion
                  Occasionally participates
                  Seldom participates
                  Not applicable
        2. Involvement in classroom activities:
                  Active, usually shows genuine interest
                  Mild, politely attentive
                  Unenergetic
                  Seldom participates
        3. Pursuit of independent study:
                  Considerable study and major project(s)
                  Some study and minor project(s)
                  No evidence of independent study
                  Not applicable
        4. Evenness of performance:
                  Even, varies no more than one mark Slightly uneven
                  Uneven, often caries two marks
                  Erratic fluctuates greatly
                  Inadequate opportunity to observe
        5. Critical and questioning attitude:
                  Often challenges
                  Occasionally probes
                  Rarely questions
                  Not applicable

USDA is an equal opportunity provider and employer
                                                                                21 | P a g e
OMB No:0503-0015

        6. Depth of understanding:
                   Excellent insight
                   Good understanding
                   Some insight
                   Little understanding
                   Not applicable
        7. Personal responsibility:
                   Always accepts fully
                   Usually accepts fully
                   Sometimes refuses
                   Often refuses
        8. Consideration for others:
                   Always considerate of others’ rights and feelings
                   Usually considerate
                   Sometimes inconsiderate
                   Often inconsiderate
        9. Population of the community in which your school is located:
                   Less than 500
                   500 – 1,500
                   1,500 – 5,000
                   5,000 – 25,000
                   25,000 – 100,000
                   Over 100,000
        10. What economic or social conditions characterize the community and most
            of the parents of the children in your school?
                   Rural farming area
                   Industrial Small
                   Large city,
                   Metropolitan area
                   Other
Teacher’s Signature
Date
This form and the candidate’s transcript must be included in the student’s application package.
Applicants applying to more than one 1890 Historically Black Land-Grant University must
submit separate USDA/1890 National Scholars application packages for each university. The
complete application packages must be postmarked by January 31, 2021.

USDA is an equal opportunity provider and employer
                                                                                      22 | P a g e
OMB No:0503-0015

                          USDA/1890 National Application Checklist

            I have read the eligibility requirements and meet all eligibility criteria.

            I have applied to each 1890 Land-Grant Institution of interest.

            I am submitting an original application and transcript to each 1890 Land-Grant
            Institution of interest (see addresses on pages 24-25 of this application).

            I completed the Candidate’s Biographical Information section.

            I have included and signed the Secondary School Report from my high school
            counselor and explained the need to have all official transcripts with a seal.

            I have included the signed School Teacher Assessment.

            I have signed and dated the application (original signature only). If under the
            age of 18 years old, parents or guardians have signed my application.

            I have enclosed the 500-800-word essay.

             I understand that the full application package must be postmarked no later
            than January 31, 2021, for consideration for the USDA/1890 National Scholars
            Program.

USDA is an equal opportunity provider and employer
                                                                                     23 | P a g e
OMB No:0503-0015

                    1890 Land-Grant Universities Liaison Directory

  Attn: USDA/1890 Program Liaison                    Attn: USDA/1890 Program Liaison
  Alabama A&M University                             Fort Valley State University
  Post Office Box 1087                               1005 State University Drive
  Normal, AL 35762                                   Pettigrew Center, Room 244
  (202) 570-3926                                      Fort Valley, GA 31030
                                                     (202) 253-4218

 Attn: USDA/1890 Program Liaison                     Attn: USDA/1890 Program Liaison
 Alcorn State University                             Kentucky State University
 1000 ASU Drive, Room 1139                           Cooperative Extension Facility
 104 Agriculture Science Building                    400 East Main Street, Room 221
 Lorman, MS 39096                                    Frankfort, KY 40601
 (202) 596-0478                                      (202) 570-5202

 Attn: USDA/1890 Program Liaison                     Attn: USDA/1890 Program Liaison
 Central State University 1400                       Langston University
 Brush Row Road                                      School of Agriculture and Applied Sciences
 McLin Building, Room 210                            100 Success Drive, Room V 115
 Wilberforce, OH 45384                               Langston, OK 73050
 (202) 596-0140                                      (202) 263-9209

 Attn: USDA/1890 Program Liaison                     Attn: USDA/1890 Program Liaison
 Delaware State University                           Lincoln University
 CARS Ag Annex, Room 108F                            818 Lee Drive; 108 Bennett Hall
 Dover, DE 1991                                      Jefferson City, MO 65101
 (202) 308-7687                                      (202) 264-0736

  Attn: USDA/1890 Program Liaison                    Attn: USDA/1890 Program Liaison
  Florida A&M University                             North Carolina A&T University
  1740 South Martin L. King Jr., Boulevard           1601 East Market Street
  Room 217, S. Perry-Paige Building                  107 B.C. Webb Hall
  Tallahassee, FL 32307-4100                         Greensboro, NC 27411
  (202) 510-6301                                     (202) 281-8214

USDA is an equal opportunity provider and employer
                                                                                24 | P a g e
OMB No:0503-0015

                    1890 Land-Grant Universities Liaison Directory

  Attn: USDA/1890 Program Liaison                    Attn: USDA/1890 Program Liaison
  Prairie View A&M University                        Tuskegee University
  P. O. Box 2736                                     College of Agriculture, Environmental
  Prairie View, TX 77446                             and Nutritional Sciences
  (202) 302-4712                                     Campbell Hall Room 103
                                                     Tuskegee, AL 36088
                                                     (202) 306-9884
  Attn: USDA/1890 Program Liaison
  South Carolina State University                     Attn: USDA/1890 Program Liaison
  300 College Avenue, N.E.                            University of Arkansas Pine Bluff
  P.O. Box 7246                                       1200 North University Drive
  Orangeburg, SC 29117                                Mail Slot: 4806
  (202) 596-4442                                      Pine Bluff, AR 71611-2799
                                                      (202) 306-9810

 Attn: USDA/1890 Program Liaison                     Attn: USDA/1890 Program Liaison
 Southern University and A&M College                 University of Maryland Eastern Shore
 Fisher Hall, Room 102                               One Backbone Road
 Baton Rouge, LA 70813                               Hazel Hall, Room 3002
 (202) 302-7255                                      Princess Anne, MD 21853
                                                     (202) 306-7368

 Attn: USDA/1890 Program Liaison
 Tennessee State University                          Attn: USDA/1890 Program Liaison
 3500 John Merritt Boulevard                         Virginia State University
 Ag Science Dept., Room 20                           P.O. Box 9081; 1 Hayden Drive
 P.O. Box 9629                                       L. Douglas Wilder Building, Room 202C
 Nashville, TN 37209-1561                            Petersburg, VA 23806
 (202) 596-0226                                      (202) 596-0301

 Attn: USDA/1890 Program Liaison
 West Virginia State University
 100 Curtis House
 P .0. Box 1000 Institute, WV 25112-1000
 (202) 596-4605

USDA is an equal opportunity provider and employer
                                                                                  25 | P a g e
OMB No:0503-0015

For questions related to this application, please contact:

The Office of Partnerships and Public Engagement - USDA/1890 Program
1400 Independence Ave. SW., Stop 0601 Washington, D.C. 20250 Telephone Number:
(202) 720-6350 Fax Number: (202) 720-7136

According to the Paperwork Reduction Act of 1995, an agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this
information collection is 0503-0015. The time required to complete this information
collection is estimated to average 2.6 to 3 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs
and activities based on race, color, national origin, gender, religion, age, disability,
political beliefs, sexual orientation, and martial or family status (not all prohibited bases
apply to all programs). Persons with disabilities who require alternative means for
communication of program information (Braille, large print, audiotape, etc.) should
contact the USDA‘s TARGET Center at (202) 720-2600 (voice and TDD). To file a
complaint of discrimination, contact the USDA Assistant Secretary for Civil Rights, 300
7th Street S.W., Suite 521, Washington, D.C. 20024 or call (202) 401-0005 or (800) 795-
3272.

USDA is an equal opportunity provider and employer
                                                                                  26 | P a g e
You can also read